Exam 4 - Diarrhea

Question 1

(T/F): fluid and electrolyte imbalance leading to dehydration is the major complication of diarrheal illness

Answer 1

True

Question 2

What can be an underlying cause of diarrhea?

Answer 2

• traveling
• foods that may have caused food poisoning
• recent vacations in children
• food intolerances

Question 3

What is a vaccination that has an ADR of diarrhea?

Answer 3

Rotavirus vaccinations in infants may have a mild adverse effect of diarrhea

Question 4

Loperamide adverse effects

Answer 4

Occasional dizziness
Constipation

Question 4

Loperamide limit

Answer 4

Used for a MAXIMUM of 48 hours

Question 5

What is the treatment of choice for mild-moderate dehydration diarrhea?

Answer 5

Fluid and electrolyte replacement w/ oral rehydration solutions

Question 6

What is the preferred agent when vomiting is the predominant clinical symptom of acute gastroenteritis?

Answer 6

Bismuth subsalicylate

Question 6

Loperamide RARE adverse effects

Answer 6

Fatigue
Dry mouth
Abdominal pain
Vomiting
Abdominal distention
Nausea
Hypersensitivity reactions

(Frank Drives A VAN Home)

Question 7

What did the FDA say in 2016 can be caused by taking a higher than recommended dosage of loperamide?

Answer 7

Serious heart problems that can lead to death

Question 7

Bismuth subsalicylate adverse effects

Answer 7

Harmless black staining of stool
Darkening of tongue

Question 8

What increases cardiovascular risk in patients who take loperamide?

Answer 8

High loperamide doses w/ inhibitors of CYP3A4, CYP2C8, or P-glycoprotein agents

Question 9

In what patient groups should you restrict use of loperamide?

Answer 9

Patient who are afebrile or have a low grade fever w/ no bloody stools

This is to avoid super infection

Question 10

Who CAN use loperamide?

Answer 10

Children 6 years and older

Question 10

Patients who are allergic to ____ can NOT take bismuth subsalicylate

Answer 10

Aspirin

Question 11

Who CAN use bismuth subsalicylate?

Answer 11

Patients older than 12

Question 12

Can you get Reye’s syndrome from using bismuth subsalicylate?

Answer 12

YES but it is rare

Question 13

What is a dose-related adverse effect of salicylate toxicity?

Answer 13

Mild tinnitus

Question 13

Abbreviations: LABA

Answer 13

Long acting beta agonist

Question 13

What patient groups can NOT use bismuth subsalicylate products?

Answer 13

• Pregnant/nursing
• Taking aspirin/salicylate containing drugs
• AIDS
• Taking tetracyclines/quinolones
• Urate lowering therapy
• Patients who have had the chickenpox/flu vaccine within 6 wks of taking BSS
• Bleeding risk

(Patients To Avoid Taking/Using Pepto Bismol)

Question 13

What may be effective in preventing and treating mild, acute, complicated diarrhea?

Answer 13

Complementary therapy

Probiotics including several lactobacillus species

Bifidobacterium lactis

Saccharomyces boulardii

Question 13

Abbreviations: ICS

Answer 13

Inhaled corticosteroid

Question 14

Abbreviations: LTRA

Answer 14

Leukotriene receptor antagonists

Question 15

Abbreviations: Rescue SABA

Answer 15

Rescue short acting beta agonist

Question 16

Exclusions to self care of diarrhea

Answer 16

• Visible blood/pus/mucus in stool
• Signs of severe dehydration
• High output (includes frequent & substantial diarrhea volumes)
• Chronic/persistent diarrhea
• Risk of significant complications (includes chronic conditions/concurrent illnesses)
• Young age (< 6 months or weighs < 8 kg)
• Severe abdominal pain/distress (tenderness and/or distention)
• Sub potential response to ORS already taken
• Persistent fever
• Pregnant

(Very Sad Hannah CRYS, So Pour Pinnacle)

Question 17

Signs of severe dehydration

Answer 17

Children showing behavioral/mental changes (irritability, apathy, lethargy, unconsciousness)

Children who have not urinated in 8 hours

Children who have no tears when they cry

Orthostatic hypotension

Question 18

Patients of young age who should NOT be treated w/ an OTC antidiarrheal

Answer 18

Patients < 6 months old
OR
Weigh < 17.5 POUNDS (not kg)

Question 19

Patients of advanced ago who should NOT be treated w/ OTC antidiarrheals

Answer 19

Frail patients
Older than 65 years old

Question 20

Patients experiencing what should not be treated w/ OTC anti-diarrheal agents?

Answer 20

Persistent fever
Blood/pus/mucus in stool
Persistent vomiting
Signs of severe dehydration
Severe abdominal pain/distress
Chronic/persistent diarrhea
Suboptimal response to ORS already administered